Spinal Cord Injury Assessment Among Older Adults
Original Editor - Tolulope Adeniji Top Contributors - Tolulope Adeniji, Kim Jackson and Vidya Acharya
Introduction[edit | edit source]
Ageing is a complex process[1] that is multi-factorial in origin, the process entails normal physiological changes that is accompany with functional decline, predisposition to some certain age related disease and increase in mortality rate.[2] Likewise, as the older adults population is on increase recent evidence also shows that the incidence of spinal cord injury among this population is on increase and this is considered double disability among this population.[3] Recently, attention has been drawn to aging with spinal cord injury, however, there is dearth of literature in this area. This page will give us an overview of assessment of ageing with spinal cord injury to bridge some of the existing gap in the literature.
Framework: International Classification of Function[edit | edit source]
Assessment of Spinal cord injury[edit | edit source]
Objective Assessment of Spinal Cord Injury Among Older Adults[edit | edit source]
Effective management of patients with spinal cord injury (SCI) requires a multi-displinary approach and knowledge of assessment of spinal cord injury and age specific is essential to see desire thereapeutic goals such as in ageing with SCI, Thus clinician like Physiotherapist who are usually involved right from the onset of SCI managenent will benefit from specific objective assessment of SCI among older adult. The main objective assessment that I will consider in this page will include neurological and cardio-respiratory assessment.
Assessment of Impairments[edit | edit source]
Objective assessment should address concerns in spinal cord injury (SCI) that include impairment in neurological system and cardiorespiratory system. Neurological system asssesment should entails assessment for neuromucular integrity such as muscle tone and spasticity, in cardiovascular system such as compromise of cardiovascular control, with associated short- and long-term consequences. For example, impaired control of the autonomic nervous system (ANS), especially in individuals with high thoracic and cervical SCI that can lead to hypotension, bradycardia, and autonomic dysreflexia.
Muscle Function[edit | edit source]
Effect of ageing on muscle function
Ageing reduces muscle function and tone.Sarcopenia is also prevalent in older adults and it accounts for massive loss in muscle mass and or function among this population, Also ageing reduce numbers of motor neurons and fast-twitch fibers, which further impaired muscle function.Therefore, it is essential to consider the impact of ageing while evaluating SCI patients for muscle function. Noreau and Vachon[4] noted that myometry technique(hand-held myometry) of assessing muscle function might be chosen over manual muscle test (MMT) and the isokinetic dynamometry (Cybex) in spinal cord injury patients. And this can be deemed suitable for the older adults population. Another measure of motor function among SCI patient is the American Spinal Injury Association (ASIA) Standards It is important to note that while considering management for spinal cord injury alleviating osteoporosis and sarcopenia, especially among older adults with SCI, is essential as these are part of complications that are associated with SCI.[5]
Sensation[edit | edit source]
Neuromuscular integrity is reduced due to ageing and this can be expressed in form of reduction in sensation including preconception and delayed in nerve conduction, Therefore, this changes is important to note while assessing this population with SCI. The American Spinal Injury Association (ASIA) Standards is one of among the common way to evaluate pin-prick and light-touch sensory function in SCI patients.
Reflexes[edit | edit source]
Reflexes in normal ageing Reflexes in ageing with sci
Joint Range of Movement[edit | edit source]
link to the physiopeida on general sci assessment important features of Joint Range of Movement with normal ageing
Balance[edit | edit source]
Respiratory Function[edit | edit source]
Cardiovascular Fitness[edit | edit source]
normal ageing ageing with sci
- Peak Oxygen Consumption Tests i.e. VO2 Peak Tests,
Pain[edit | edit source]
normal ageing ageing with sci
Assessment of Activity[edit | edit source]
normal ageing ageing with sci
General Mobility (including Bed Mobility and Transfers)[edit | edit source]
link to the physiopeida on general sci assessment normal ageing ageing with sci
Wheelchair Mobility[edit | edit source]
for ageing with sci
Gait[edit | edit source]
for ageing with sci
Upper Limb and Hand Function[edit | edit source]
for ageing with sci
Assessment of Participation[edit | edit source]
for ageing with sci
Family[edit | edit source]
for ageing with sci
Education[edit | edit source]
for ageing with sci
Work[edit | edit source]
for ageing with sci
Leisure[edit | edit source]
for ageing with sci
Environmental Factors[edit | edit source]
for ageing with sci
Resources[edit | edit source]
Assessment of older adults with SCI
References[edit | edit source]
- ↑ McCormick MA, Tsai SY, Kennedy BK. TOR and ageing: a complex pathway for a complex process. Philosophical Transactions of the Royal Society B: Biological Sciences. 2011 Jan 12;366(1561):17-27.
- ↑ Borysławski KR, Chmielewski PI. A prescription for healthy aging. Aging. Psychological, biological and social dimensions. Wrocław: Agencja Wydawnicza „Argi. 2012:33-40.
- ↑ Pili R, Gaviano L, Pili L, Petretto DR. Ageing, Disability, and Spinal Cord Injury: Some Issues of Analysis. Current Gerontology and Geriatrics Research. 2018 Nov 19;2018.
- ↑ Noreau L, Vachon J. Comparison of three methods to assess muscular strength in individuals with spinal cord injury. Spinal cord. 1998 Oct;36(10):716-23.
- ↑ Giangregorio L, McCartney N. Bone loss and muscle atrophy in spinal cord injury: epidemiology, fracture prediction, and rehabilitation strategies. The journal of spinal cord medicine. 2006 Jan 1;29(5):489-500.
